Stiff little fingers

Stiff little fingers

At the end of August, I returned from a three-month, 4,000-mile tour. The grips I used were the ergo type, and my gears were twist-grip Rohloff. During the last month of the tour, I found that both my little fingers were becoming painful and difficult to bend, at their worst becoming stuck in the bent position. My left hand has since improved but my right hasn’t. I visited the doctor, followed by a specialist appointment, during which I was given an injection of cortisone at the base of the finger. If this doesn’t work, I can opt for an operation. Could you explain what this condition is and whether there is anything I can do to avoid it? I’m planning another long tour next year.

Chris Parkinson

This sounds like trigger finger, a condition where one of the fingers (or thumb) may click or become stuck as you bend it towards the palm. It is often painful, and sometimes the finger becomes locked in a bent position and can only be released manually using the other hand.

Trigger finger is caused by a swelling or nodule on one of the flexor tendons, the tendons on the palm side of the hand that bend each finger. This then catches on the tendon’s covering sheath as it moves to bend (flex) the finger.

In most cases, it is unclear why certain people develop trigger finger, and there is usually nothing you can do to prevent it occurring. In milder cases, avoiding exacerbating activities may reduce the symptoms. Rather than giving up cycling though, it might be worth trying different grips to alter the position of your hands on the handlebar, just to see if this helps. If it doesn’t, other options for treatment include a local corticosteroid injection (which you have already had on one side), or surgery to release the affected tendon sheath.

Steroid injections are usually worth trying first as they are often effective and are generally safe. They work by reducing the swelling. However, it may take several weeks to see the full benefit. If a steroid injection is unsuccessful then a simple surgical procedure to release the tendon is the most likely ‘cure’. This is usually done as a day-case procedure under local anaesthetic, but it would be likely to stop you cycling for several weeks afterwards.